198009834-1-23-2023-33-CC-RLOZ-CND3TK-20230123173204

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198009834
Report Date: 01/23/2023
Date Signed: 01/23/2023 05:32:12 PM

Document Has Been Signed on 01/23/2023 05:32 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	ANNEX MONTESSORI CHILDCARE CENTER		FACILITY NUMBER:	198009834
ADMINISTRATOR:	HAYDEE DIAZ		FACILITY TYPE:	830
ADDRESS:	3400 AEROJET		TELEPHONE:	(626) 569-2641
CITY:	EL MONTE	STATE: CA	ZIP CODE:	91731
CAPACITY:	10	CENSUS: 4	DATE:	01/23/2023
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	01:35 PM
MET WITH:	Director Anahi Salinas		TIME COMPLETED:	02:35 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Roxana Lopez conducted a case management inspection, following a complaint investigation on this date. LPA met with Director, Anahi Salinas who gave analyst a tour of the facility. During the inspection of the infant classroom, LPA observed 1 teacher with 4 infants in the napping room. LPA observed 2 infants asleep with blankets on top of them. This poses and immediate health, safety or personal rights risk to persons in care. LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. --------------------- pg.1 of 2 ------------

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ANNEX MONTESSORI CHILDCARE CENTER	FACILITY NUMBER: 198009834
	VISIT DATE: 01/23/2023

NARRATIVE

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A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Based on the LPA’s observations and records reviews, the following deficiency listed on the attached LIC 809D (deficiency page) is being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety.

LPA Roxana Lopez informed facility representative Anahi Salinas that this report dated 1/23/2023 document(s) 1 Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Roxana Lopez informed the facility representative to provide a copy of this licensing report dated 1/23/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the facility representative Anahi Salinas

----------------------------------------------------pg. 2 of 2 -----------------------------------------------------------------

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 01/23/2023 05:32 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ANNEX MONTESSORI CHILDCARE CENTER	FACILITY NUMBER: 198009834
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/23/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 01/23/2023 Section Cited	1 2 3 4 5 6 7	101223 Personal Rights(a)The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.	1 2 3 4 5 6 7	During inspection Director removed- blankets from infants. Per director, they will have a staff meeting to discuss safe sleep regulations and watch personal rights violation videos at ccld.childcarevideos.org and submit meeting minutes, sign in sheet
	8 9 10 11 12 13 14	This requirement is not met as evidenced by:Based on LPA's obervations, the licensee did not comply with the section cited above in that LPA observed two infants asleep in cribs with blankets on top of them, which poses an immediate health, safety or personal rights risk to persons in care.	8 9 10 11 12 13 14	a declaration of what they learned and plan moving forward to LPA by 1/30/2023
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2023

LIC809 (FAS) - (06/04)

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